THE BLOG

Mental Health Act - Unethical Paternalism?

14/02/2014 12:22 GMT | Updated 15/04/2014 10:59 BST

What is it like having all of your freedom taken off of you, put in the hands of professionals? In what circumstances is it unethical to detain someone under the Mental Health Act?

The MHA should only be used as a last resort as a safeguard for any forms of harm as it deprives an individual from their liberty. If a patient is well enough to return home to their own freedom and independence, then they should have that option.

I have strong views on this, having experienced it first hand. Tribunals are available for patients detained, but are they really as balanced as they claim? Who would you believe - a vulnerable patient or an experienced doctor? It will always be biased in favour of the MH professional's opinion. And this is why many people are still detained unethically. My reason behind this article is to bring some awareness to the act, and considerations of its effects.

When someone is no longer at risk from immediate harm to themselves or others, there is no reason to keep them detained against their will. There are sometimes situations where consultants keep the mental health act on "just to be cautious", "just in case". Because, in their words - the section isn't interfering with recovery; so why not keep it on?

Why? Because it is an infringement of liberty, an infringement of civil rights. When people are no longer seriously ill with a mental illness, there is no justification for it. It is an extreme measure that should only be applied when it is absolutely necessary, not just for convenience.

It is an issue close to heart - I lost an appeal to a Section 3, despite the treatment team admitting to me countless of times in private (although not in the Tribunal of course) that I was "no longer seriously ill with anorexia".

Three months on, I was physically healthy; psychologically I was nourished, competent, capable of making my own decisions. This was in comparison to my admission, where my cognitive abilities were impaired. The consultant's reasoning was "just to be cautious", "just in case". I understand that my admission was warranted, but there was no justification from depriving me of my liberty when mentally and physically I was healthy. It felt horrible; mental health aside - it felt like an infringement of my rights.

The Tribunal I experienced was biased in favour of the professionals, and my life was left under the control of a psychiatrist who in no circumstances would lift the restrictions. The psychiatrist even tried to get the same social worker in to the MHA process so that it was more likely to succeed. I felt helpless and restricted, and there was little I could do about it.

There are some circumstances where people are treated differently than others. When some people are refused help that they need, people that do not need the help are forced to accept it. For example, I watched the treatment team let many ill patients discharge, when I was no longer ill. The power is in the hands of individual psychiatrists. They have the power to keep a well service-user away from their home and family. It is said that there is safeguards - the Tribunals service, the Hospital Manager appeal... But usually the outcomes always favour the professional, and very few appeals are actually successful. The service-user cannot deny they have a mental illness, and this is where the professionals succeed.

I acknowledge that some people do warrant detention, and I'm not disagreeing with the ethics of the Mental Health Act in general. In my experience, although it was warranted at first - after time it was misused, and my liberties were restricted for convenience.

It brings in the issue - within the process of the MHA and appealing - judges, laypeople, managers; It is likely that they will always favour the opinion of the professional over a young person. And sometimes I believe it is unethical.